Artikel
Dynamic cerebral autoregulation in patients with intracranial tumours
Dynamische zerebrale Autoregulation bei Patienten mit Hirntumoren
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Autoren
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Kirsten Schmieder
- Department of Neurosurgery, Ruhr-University, Bochum
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M. Engelhardt
- Department of Neurosurgery, Ruhr-University, Bochum
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C. Brenke
- Department of Neurosurgery, Ruhr-University, Bochum
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U. Linstedt
- Department of Anesthesiology, Ruhr-University, Bochum
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A. Harders
- Department of Neurosurgery, Ruhr-University, Bochum
| Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
Alterations of cerebral perfusion in brain parenchyma adjacent to tumours are reported. The possible negative consequences of intraoperative management of blood pressure and fluid replacement are of great significance for the patient. The aim of this study was to test dynamic cerebral autoregulation in patients scheduled for tumour resection.
Methods
Dynamic cerebral autoregulation was evaluated pre-operatively using bilateral transcranial Doppler sonography and the thigh cuff method to alter arterial blood pressure in 50 patients (26 females and 24 males) with a mean age of 49.8 years (range 15-73 years). Patients were investigated prior to the induction of narcosis, in narcosis under normoventilation and hyperventilation, and after surgery. The alterations of cerebral autoregulation were correlated to size, location and histology of the tumour and the presence of accompanying diseases.
Results
Mean dynamic cerebral autoregulation was normal in all patients. 58% of the tumours were located in the frontal lobe. Thirteen patients had tumours ≤4cm, in 13 patients tumour size was >4 – 6cm and in 10 patients tumours were larger than 6cm. Location, size or histological classification of the lesion was without influence on autoregulation. The patients with accompanying diseases, such as diabetes mellitus and/or hypertension had significantly lower autoregulation values prior to surgery, and a significantly lower increase after hyperventilation.
Conclusions
Cerebral autoregulation is preserved in patients with intracranial tumours regardless of tumour size, if the clinical status of the patient is good. The influence of accompanying diseases was demonstrable and should be considered in perioperative management.
